Sánchez Jorge, Cherrez-Ojeda Iván, Álvarez Leidy, Ensina Luis-Felipe, Muñoz Nelson, Muñoz Daniela, Olivares-Gómez Margarita, Muñoz Danny, Ramon German, Rocha-Felix Mara-Morelo, Torres Pablo, Jaller-Raad Rodolfo, de Los Rios Elsie, Rosário Cristine, Ale Iris, Jiménez Emilio, Rodríguez-Alvarez Ligia-Aurora, Ricaurte Marcela
Group of Clinical and Experimental Allergy (GACE), Hospital (Alma Mater de Antioquia), University of Antioquia, Medellín, Colombia.
Universidad Espíritu Santo, Samborondón, Guayas, Ecuador.
World Allergy Organ J. 2023 Nov 1;16(11):100832. doi: 10.1016/j.waojou.2023.100832. eCollection 2023 Nov.
The prevalence of atopic dermatitis (AD) is increasing in developing countries. Different worldwide guidelines have been proposed, but their applicability for AD specialists in Latin American (LA) countries is unknown.
The objective of this study was to explore the medical approach to treating AD in LA countries.
The study population comprised AD specialists (allergists and dermatologists). They completed an electronic survey containing questions about the health system, diagnostic criteria, and pharmacotherapy approach to treating AD. The survey was constructed and validated by the Atopic Dermatitis Committee of the Latin American Society of Allergy Asthma and Immunology (SLAAI) in Spanish and Portuguese. Each member was responsible for distributing the questionnaire through different networks in their respective countries.
A total of 284 AD specialists from 13 LA countries completed the questionnaire; among them, 67% were allergists and 33% were dermatologists. Less than 50% of the AD specialists strictly followed guideline recommendations. Among the AD specialists, the European and North American guidelines were more frequently used, and only 16% followed LA guidelines. Dermatologists used the local guidelines less frequently than allergists. Most physicians did not routinely use AD assessment tools (55%). The frequency of the diagnostic tests depends on symptom severity. The availability of some systemic treatments, such as biologics and Janus Kinase (JAK) inhibitors, is not universal in all LA countries.
There were marked differences between the specialists, and these differences seemed to be affected by their specialty and each country's healthcare system. New AD education strategies that consider the particularities of the region could allow patients to be more accurately managed. AD assessment tools may provide a way to enhance AD treatment and allow for shared decision-making, patient empowerment, and standardized care.
发展中国家特应性皮炎（AD）的患病率正在上升。世界各地已提出了不同的指南，但这些指南对拉丁美洲（LA）国家的AD专科医生的适用性尚不清楚。
本研究的目的是探讨拉丁美洲国家治疗AD的医学方法。
研究人群包括AD专科医生（过敏症专科医生和皮肤科医生）。他们完成了一项电子调查问卷，其中包含有关卫生系统、诊断标准和AD治疗药物疗法的问题。该调查问卷由拉丁美洲过敏、哮喘和免疫学协会（SLAAI）特应性皮炎委员会用西班牙语和葡萄牙语编制并验证。每个成员负责通过各自国家的不同网络分发问卷。
来自13个拉丁美洲国家的284名AD专科医生完成了问卷；其中，67%为过敏症专科医生，33%为皮肤科医生。不到50%的AD专科医生严格遵循指南建议。在AD专科医生中，欧洲和北美的指南使用更为频繁，只有16%遵循拉丁美洲的指南。皮肤科医生比过敏症专科医生更少使用当地指南。大多数医生没有常规使用AD评估工具（55%）。诊断测试的频率取决于症状的严重程度。一些全身治疗药物，如生物制剂和Janus激酶（JAK）抑制剂，在所有拉丁美洲国家并非普遍可用。
专科医生之间存在明显差异，这些差异似乎受其专业和每个国家医疗保健系统的影响。考虑到该地区特殊性的新的AD教育策略可以使患者得到更准确的管理。AD评估工具可能提供一种加强AD治疗的方法，并有助于共同决策、患者赋权和标准化护理。
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